1. Combination Treatment with Intravenous Tigecycline and Intraventricular and Intravenous Colistin in Postoperative Ventriculitis Caused by Multidrug-resistant Acinetobacter baumannii
- Author
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Cezar José Mizrahi, Samuel Moscovici, Mony Benifla, Shmuel Benenson, Carlos Candanedo, and Sergey Spektor
- Subjects
medicine.medical_specialty ,Combination therapy ,medicine.medical_treatment ,Neurosurgery ,Infectious Disease ,Tigecycline ,multidrug-resistant acinetobacter baumannii ,Pediatrics ,Ventriculitis ,polycyclic compounds ,ventriculitis ,Medicine ,colistin ,Craniotomy ,biology ,business.industry ,General Engineering ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,biology.organism_classification ,bacterial infections and mycoses ,Acinetobacter baumannii ,Anesthesia ,Colistin ,bacteria ,carbapenem-resistant acinetobacter baumannii ,lipids (amino acids, peptides, and proteins) ,tigecycline ,business ,Complication ,medicine.drug - Abstract
Nosocomial infections with multidrug-resistant (MDR) pathogens are a life-threatening complication in neurosurgery. An MDR Acinetobacter baumannii (A. baumannii) central nervous system (CNS) infection following neurosurgery has been previously reported and was treated with relative success using intraventricular and/or intravenous (IV) colistin, IV tigecycline, or IV colistin-rifampicin combination therapy. We present a case of MDR A. baumannii in a 13-year-old girl following parietal craniotomy for the resection of a right intraventricular meningioma. Several days after surgery, the patient presented with clinical, radiological, laboratorial, and microbiological evidence of carbapenem-resistant A. baumannii ventriculitis. She was treated with IV colistin and then with combined intraventricular-IV colistin, with partial failure. The combined treatment of IV tigecycline and associated intraventricular and intravenous colistin was started and significant improvement was seen clinically and radiologically, with negative cultures after one week. To the best of our knowledge, this is the first case of a successful combination of intraventricular and IV colistin combined with IV tigecycline after a partial treatment failure with intraventricular and IV colistin alone.
- Published
- 2019